Use of transesophageal echocardiography for transcatheter valve-in-valve implantation for patients with prior bioprosthetic surgical aortic, mitral, tricuspid, and pulmonic valves

• Authors: Ankit Bhargava, Emory University; Nikoloz Shekiladze, Emory University; Joe Xie, Emory University; Annapoorna Kini, Icahn School of Medicine at Mount Sinai; Patrick Gleason, Emory University; Stamatios Lerakis, Emory University
• Journal Title: ANNALS OF CARDIOTHORACIC SURGERY
• Volume: Volume 10, Number 5
• Publisher: AME PUBLISHING COMPANY | 2021-09-01, Pages 605-620
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.21037/acs-2021-tviv-27
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Surgery; Cardiovascular System & Cardiology; Valve-in-valve (ViV); transcatheter aortic valve replacement (TAVR); transcatheter mitral valve replacement (TMVR); BASILICA; LAMPOON; OUTFLOW TRACT OBSTRUCTION; CORONARY OBSTRUCTION; REPLACEMENT; OUTCOMES; PREDICTORS; PREVENT

Abstract

Valve-in-valve (ViV) transcatheter procedures are the preferred option for redo valve replacement in patients who otherwise would be high risk for surgery. Transesophageal echocardiography (TEE) is an integral imaging modality for both peri-procedural and intra-procedural guidance during transcatheter ViV replacement. When intentional leaflet laceration is needed, such as with the BASILICA (Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstructions during TAVR) or LAMPOON (Laceration of the Anterior Mitral valve leaflet to Prevent left ventricular Outlet ObstructioN) procedures, TEE is critical to proper guidewire positioning and achieving a successful laceration. In this paper we detail the role of TEE in ViV transcatheter valve replacement in patients with prior surgical aortic, mitral, tricuspid, and pulmonic valves.